[Materials and Methods] Perioperative factors and clinicopathological features of eleven patients (4 male and 7 female, median age was 71 years old [17-85]) who had lap-APR in Tohoku University Hospital from 2008 to 2015 were compared to those of forty-four patients with open-APR in the same period.

[Results] Patient’s stage of lap-APR group was I/II/III/IV = 8:1:2:0. On the other hand, that of open-APR group was I/II/III/IV = 8:12:14:10, suggesting that lap-APR tended to be performed for patients with early stage disease. Patients in lap-APR showed statistically less blood-loss (64 vs 1030 ml, p<0.0001) and significantly shorter operative time than that of open-APR (291 vs 385 min, p=0.0256). There was no significant difference between lap-APR and open-APR in hospital-length of stay (22 vs 33 days, p = 0.19). Post-operative complications were less in lap-APR; Clavien-Dindo grade >or=3 was 9% in lap-APR and 32% in open-APR, respectively.

[Conclusion] Although further large clinical studies are needed, this retrospective study suggests that lap-APR is safe and less invasive approach for the patients with lower rectal cancer.